Costs grow faster for states lacking Medicaid expansion

By BOBBY HARRISON

Barely a word was spoken of possible Medicaid expansion recently during meetings of legislative working groups formed by House Speaker Philip Gunn and Lt. Gov. Tate Reeves to look at state’s revenue collections and expenditure.

Instead, the focus of the working group dealing with Medicaid was the growth in the existing state program that Executive Director David Dzielak said does not provide health care coverage for able-bodied adults, except for poor pregnant women. That program has grown from $763 million in state funds in fiscal year 2012 to at least $948.6 million for the current fiscal year.

That growth in state spending on Medicaid has been cited by Mississippi’s political leadership as a reason not to expand Medicaid. Expansion is allowed under the federal Patient Protection and Affordable Care Act, known as Obamacare, to cover the working poor. It has been estimated that the expansion could add 300,000 adults to the Mississippi Medicaid rolls. But a study by the nationally known non-profit Henry Kaiser Family Foundation found that in fiscal year 2015, state spending on Medicaid was more in the then-22 states that had not expanded Medicaid than in the then-29 states that had expanded. State spending on Medicaid grew by 3.4 percent in the expansion states and by 6.9 percent in the non-expansion states, including Mississippi.

For the first two years of the expansion, the federal government paid 100 percent of the costs of treatment for the new enrollees, explaining why there were not more costs to the states.

But starting in 2017, the amount paid by the federal government will drop to 95 percent and eventually to 90 percent in 2020.

“It has cost us about $1 billion in federal funds by not expanding,” said Rep. Steve Holland, D-Plantersville, adding the expansion would be a boon for health care and the state’s economy.

But many others, particularly the Mississippi’s Republican leadership, said the Medicaid budget already is a drain on state revenue collections.

“Instead of assuming enormous costs that we cannot afford, I would suggest that we spend our time and efforts in finding good jobs for all Mississippians. We should be compassionate by lowering our Medicaid population through economic growth, personal responsibility, and providing more access to private sector health care,” Bryant said during his 2015 re-election campaign.

The Kaiser study revealed that federal funding and Medicaid enrollment increased by about 18 percent in expansion states – significantly faster than in non-expansion states.

In recent days, the Mississippi State Medical Association, which is comprised of many of the state’s physicians, has endorsed using the Affordable Care Act to improve access to heath care in the state while not citing Medicaid expansion by name. Also, the Mississippi Hospital Association has reiterated its support for Medicaid expansion.

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